Provider Demographics
NPI:1497927404
Name:LEMAS, KEREN MIREYA (IDC)
Entity Type:Individual
Prefix:MS
First Name:KEREN
Middle Name:MIREYA
Last Name:LEMAS
Suffix:
Gender:F
Credentials:IDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2450 CRAVEN ST
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92136-5599
Mailing Address - Country:US
Mailing Address - Phone:619-556-8114
Mailing Address - Fax:619-556-9489
Practice Address - Street 1:2450 CRAVEN ST
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92136-5599
Practice Address - Country:US
Practice Address - Phone:619-556-8114
Practice Address - Fax:619-556-9489
Is Sole Proprietor?:No
Enumeration Date:2008-03-31
Last Update Date:2008-03-31
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1003XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Medical Technicians